Interpolated Paramedian Forehead Flaps

Abstract

Median forehead flaps were first described in an Indian medical treatise, the Sushruta Samita, in approximately 700 BC.1 ^– 3 The operation was performed by members of a caste of potters known as the Koomas. The need for this operation arose from the common Indian practice of amputating the tip of the nose as punishment for a variety of crimes, ranging from robbery to adultery.4 ^,5 The first reported use of the median forehead flap outside of India was by Antonio Branca of Italy. Based on an Arabic translation of the Sushruta Samita, Branca performed a nasal reconstruction using the mid-forehead flap in the fifteenth century.6 ^, 7 In the sixteenth and early seventh centuries, little advancement was made in the use of the median forehead flap because plastic and reconstructive surgery fell into disrepute.4 ^,5^,7 The flap had a revival in 1794, when J.C. Carpue read an editorial in the Gentlemen’s Gazette of London describing the flap’s use for nasal reconstruction.8^–10 Initially, Carpue practiced the median forehead flap operation on cadavers.